Provider Demographics
NPI:1104011865
Name:KRAMER WOLF, CYNTHIA ANN (ME, LPC-S, RPT-S)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:ANN
Last Name:KRAMER WOLF
Suffix:
Gender:F
Credentials:ME, LPC-S, RPT-S
Other - Prefix:MS
Other - First Name:CYNTHIA
Other - Middle Name:ANN
Other - Last Name:WOLF
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ME, LPC-S, RPT-S
Mailing Address - Street 1:4815 S HARVARD AVE STE 480
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-3050
Mailing Address - Country:US
Mailing Address - Phone:918-607-2337
Mailing Address - Fax:
Practice Address - Street 1:4815 S HARVARD AVE STE 480
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-3050
Practice Address - Country:US
Practice Address - Phone:918-607-2337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-06
Last Update Date:2014-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3179101YP2500X
TX15416101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional